HIP reconstruction in children with loss of the femoral head secondary to infection

ABSTRACT

A prospective study was performed at the Department of the Orthopedic Surgery, Assiut University Hospital, Assiut, Egypt during the period between 1994 and 1996. The age of the patients at the time of surgery ranged between 2.5 and 7 years, with an average of 4 years and 8 months. Clinical and radiological measurements of limb length were performed preoperatively, postoperatively and at follow up for all patients. Colonna hip arthroplasty procedure for non-united femoral-neck fractures has been reported, in which the greater trochanter is placed in the acetabulum and the abductor muscles of the hip are transferred distally on the femoral shaft to improve their function. A modified Colonna procedure has been used for the treatment of pathological dislocation of the hip secondary to pyogenic infection in five children. The modification made in the procedure is its combination with proximal femoral varus osteotomy that is fixed by plate and screws. All patients had full hip extension. No patient had adduction, abduction or flexion contracture of the affected hip at the final follow up. However, compared with the preoperative range of motion, all operated hips decreased the range of motion at a different degree. The average gain in the limb length was 46% of the original discrepancy. Gait was initially improved in all patients. However, in all patients the limp has persisted, for some degree